The present invention concerns a device connected to hole punching pliers, which are arranged to punch holes in a protective plate for a stoma bag, and where the nose of the pliers is equipped with co-operating hole punching remedies in the shape of a hole socket and a holding-up plate for said socket.
A considerable number of the population, approximately 4% or a good 13000 persons in Norway alone, are in a situation of having been stoma operated and having to live with laid out intestine. The remedy used by a stoma operated person to handle the feces from the intestine end, which has been laid out from the body, is a stoma bag. The bag is secured to the body by means of a skin protecting plate where holes have been made to introduce the intestine end into the bag. The plate is fitted with a glue part on the skin side, so that it may be secured to the body. The size of each individuals intestine end will vary with time, meaning the hole has to be constantly changed. The difference is normally between 1 and 3 mm. Likewise, the size of the intestine differs form person to person.
Thus, the plate may not be fitted with a uniform opening for the intestine end. The individual may also not use plates having identical holes, as the size of the intestine may have altered once the plate has to be changed. Some persons change plate and bag as often as 1-3 times daily, while for others 2-3 weekly changes may be sufficient. The difference in intestine size is assumedly the reason why the suppliers promoting bags and plates prescribe the hole be cut with scissors.
In practice it turns out that the cutting of holes with scissors leads to great disadvantages to most users. One disadvantage is due to the fact that the plate is relatively thick in the area where it is to be cut, meaning the hole will have a jagged edge and accordingly not fit tightly enough around the intestine end.
The feces are cauterizing and cause discomfort, especially sore skin, if an uneven cut leads to skin coming into contact with feces. It is therefore not unusual that several plates have to be cut before an acceptable result is achieved. Alternatively, the leaks around the intestine end, resulting from an unevenly cut hole, may be sealed by means of a paste.
As it is impossible to control the defecation, it is preferable that the changing of plate and bag be as rapid as possible.
Before a new bag and plate can be fitted, the intestine has to be controlled for size, which can first be effectuated after the removal of the used bag and plate. It is thus hard to avoid contact between feces and naked skin or clothing, especially when knowing that the most experienced users need up to 10 minutes to cut a suitable hole. Elderly users may have trouble with the cutting.due to shaking hands etc. The hole may also not be cut to fit too tightly, as it causes discomfort when the intestine end is squeezed. Moreover, many users feel mental unease caused by the dread of the discomfort of a wrongly adjusted hole.
As it is not unusual that 2-3 plates have to be cut before the hole is as required, it is evident that the cutting also has unwanted economic results.
It is true that pliers based on hole punching operations carried out more or less in one operation, instead of cutting, are known, cf. e.g. U.S. Pat. No. 4,817,287. These known hole punching pliers are generally constructed as a pair of scissors having two elements which are pivotally connected to each other by means of a cross member, and where the two parts of the pivotal elements positioned on one side of the member create handles, while the free ends of the element parts on the other side of the member carry a so-called hole socket and a holding-up plate for the hole socket at their free end, as the punching of holes in a suitable plastic material for the skin protection plate obviously takes place with this placed between the hole socket and the holding-up plate.
In these known hole making pliers the hole socket, as well as the holding-up plate are secured to the end of the respective pivotal pliers. In such a constructive embodiment of the hole making pliers one pair of pliers is needed for each hole dimension.
It is furthermore a disadvantage concerning these known hole making pliers that the hole socket and the holding-up plate have to be dimensioned with precision and placed very accurately in relation to each other to achieve that the free working edge circumference of the hole socket hits the opposed surface of the holding-up plate as perpendicularly as possible, thus to secure cleanly cut hole edges in the skin protection plates of the stoma bags.
Concerning the above described known hole making pliers, an embodiment is shown in which a circumferential slot is formed in the holding-up plate, being nearly complementarily shaped to the outer, free cutting edge part of the hole socket. Also in other embodiments of the pliers, of this and similar natures,xe2x80x94having one and the same dimension of pliersxe2x80x94the free cutting edge of the hole socket will hit the opposed surface of the holding-up plate almost identically with every hole making operation, so that the holding-up plate is constantly worn in the same place, and is damaged.
The scope of the invention has i.a. been to remedy, or to a substantial degree reduce, the defects, the disadvantages and the limitations of application in known techniques, and thus provide a pair of hole punching pliers where the necessary measures are taken, partly to facilitate an exchange of hole sockets having different diameters, partly to secure correct adaptation between hole socket and holding-up plate during each hole punching operation, and partly to postpone damaging wear on the holding-up plate, thus providing it with an extended useful duration.
To realise the above mentioned scope, the invention distinguishes itself in the features designated in the characterizing clause of claim 1.
According to the invention the hole socket and/or the holding-up plate are placed restrictedly pivotally around separate axes stretching perpendicularly on the symmetrical axis of the hole socket, respectively of the holding-up plate. This secures the correct adaptation of the free cutting/punching edge area of the hole socket in relation to the opposed holding-up surface, that is, with said free cutting edge area directed perpendicularly towards said holding-up plate surface, with the intermediate skin protection plate.
To distribute the wear from the free cutting edge of the hole socket onto the holding-up plate, it is convenient for the holding-up plate to have a freely pivotal bearing around an axis which runs parallel to its symmetrical axis, and eccentrically in relation to the symmetrical axis. Thus the abutment of the outer, free cutting edge of the hole socket on the holding-up plate will relocate from one hole punching operation to the next, so that the said wear will be distributed over the holding-up plate.
The fact that the holding-up plate is freely pivotal also means that users who do not possess the strength required to push the hole socket through the skin protection plate, may rotate the holding-up plate once the pliers are squeezed, and may thus achieve a cutting effect.